The Disabled Poor* Need a Healthier Community to Return to in the Aftermath of Hurricane Katrina
|James H. Rimmer, Ph.D., Director|
What will always stand out in my mind are the images of the disabled poor fighting to stay alive under the most extreme conditions. Many were malnourished and deconditioned, barely able to move; others were severely overweight, having to fight for every breath of air in choking 90-degree temperatures. Emotional and physical stress, issues with weight, frailty, lack of strength and stamina, and fear of water had a substantial effect on determining who survived and who did not.
Stronger levees won't address the devaluation of human life among the disabled poor. They need a way to empower themselves so that they can retain or restore a sense of dignity and self-worth; a way to improve their health and function so that they can deal with large crises such as the one we have just witnessed, as well as the smaller crises associated with the physical and emotional hardships of living in poverty.
It may sound somewhat shallow and naive to be advocating for health promotion for the disabled poor at a time when everyone is focusing on better evacuation systems. However, when you step back for a moment and consider that many of the people who did not make it out alive were likely to be the disabled poor, many of whom were elderly, you have to wonder how many more people could have been saved had they had certain survival skills to deal with these critical situations. A small amount of strength and endurance, proper breathing techniques such as diaphragmatic and pursed lip breathing, knowledge of how to avoid dehydration, and having less fear of water could have meant the difference between life and death.
Fitness and health are traits that everyone can improve regardless of their age or disability. During times of emergency, this would mean being able to climb, pull or lift oneself up a few steps; wade or walk in shallow or waist-deep water; crawl or slide within earshot of a rescue team; hold onto the shoulders of a loved one; or evacuate a burning building. If given the right resources and opportunities, the disabled poor could improve their health and fitness quite substantially.
Stronger levees will not hold back the flood of illness and despair that many of the disabled poor must endure every day of their lives. When the flood waters recede, what you won't see under the rubble are the farmer's markets, food co-ops, fitness centers, outdoor parks, bike lanes, accessible buses and vans, and other nice features that those living in more affluent communities take for granted. Amidst all the talk about rebuilding New Orleans and the $150 billion price tag that goes with it, we must not lose sight of the fact that rebuilding a community must include the people living in it, many of whom are disabled and poor. This is the right time for our federal government to begin directing resources at restoring an environment that will be much more disability friendly and health-oriented than what was present before the storm. Instead of the typical 24-hour gas/grocery stores that are devoid of healthy food choices, provide economic incentives to encourage stores like Wild Oats and Whole Foods to move into the community and provide discounts for the poor so that they can afford to shop in these stores. Hold accessible tai chi classes in outdoor parks, hip hop classes for children in neighborhood streets, work-site yoga and relaxation classes, walking/wheeling clubs, and peer buddy health partnerships. Install proper curb cuts, wider sidewalks, bike lanes, good lighting, lots of greenery, and a local health council that does not allow every street corner to be overrun with fast food restaurants and 24-hour gas stations. Develop community centers that teach people proper etiquette, methods of dealing with stress, and how to stay resilient. Instead of constructing more housing projects, provide people with a humane place to live where they can grow their own gardens. Surely this is the 'perfect storm' to make the not-so-talked-about side of town an example for the rest of the nation's poverty-stricken communities.
* Note: The director chose not to use people-first terminology in this month's column to reflect a sense of urgency regarding the needs of individuals with disabilities living in poverty. The phrase 'disabled poor' reflects a severely underserved population that needs immediate attention from public policy makes in terms of improved living environments (disability-friendly) and greater attention to health promotion.